Method and apparatuses for accessing and/or modifying a target patient tissue site

Abstract

A modular dilation device is provided for inserting multiple dilators into a target patient tissue site. The modular dilation device includes a first dilator and a second dilator. The first dilator has a first dilator distal end and a first dilator inner lumen. The first dilator has a first dilator side wall opening. The first dilator distal end has a first dilator open tip. The first dilator has a first dilator open slit. The first dilator open slit extends between the first dilator side wall opening and the first dilator open tip. The second dilator has a second dilator distal end and a second dilator inner lumen. The second dilator distal end has a second dilator open tip. When the second dilator is joined to the first dilator, the second dilator open tip is adjacent to the first dilator side wall opening.

What is claimed is: 
     
       1. A method for inserting multiple dilators into a target patient tissue site, the method comprising:
 providing a modular dilation device including a first dilator, the first dilator having an elongate first dilator body and a first dilator distal end, the first dilator having a first dilator outer surface and a first dilator inner lumen, the first dilator distal end having a first dilator open tip, the first dilator having a first dilator side wall opening, the first dilator side wall opening selectively placing the first dilator outer surface in fluid communication with the first dilator inner lumen, and 
 a second dilator, the second dilator having an elongate second dilator body and a second dilator distal end, the second dilator having a second dilator inner lumen, the second dilator distal end having a second dilator open tip; 
 inserting a guidewire distal end of a guidewire into a target patient tissue site through a patient tissue access point; 
 directing a guidewire proximal end into the first dilator open tip, through at least a portion of the first dilator inner lumen, and out of the first dilator through the first dilator side wall opening; 
 directing the first dilator to the target patient tissue site along the guidewire; 
 directing the guidewire proximal end into the second dilator open tip, through at least a portion of the second dilator inner lumen, and out from the second dilator; 
 and directing the second dilator to the target patient tissue site along the guidewire until the second dilator open tip is adjacent to the first dilator side wall opening. 
 
     
     
       2. The method of  claim 1 , including:
 placing the second dilator into a predetermined relationship with the first dilator, wherein the second dilator open tip is adjacent to the first dilator side wall opening; 
 directing the guidewire proximal end into the first dilator open tip and out of the second dilator, wherein the guidewire proximal end is directed through the first dilator open tip and at least a portion of the first dilator inner lumen, through the first dilator side wall opening, through the second dilator open tip and the second dilator inner lumen, and out from the second dilator; and 
 collectively inserting both the first dilator and the second dilator into the target patient tissue site along the guidewire. 
 
     
     
       3. The method of  claim 1 , wherein the first dilator has a first dilator open slit, the first dilator open slit extending between the first dilator side wall opening and the first dilator open tip, the first dilator open slit including a first dilator open slit first surface and a first dilator open slit second surface, the first dilator open slit first surface being oppositely facing and abutting the first dilator open slit second surface, the first dilator open slit first surface and the first dilator open slit second surface being selectively elastically separable, and the second dilator open tip and at least a portion of the second dilator distal end are each smaller in diameter than at least one of the first dilator inner lumen and the first dilator side wall opening, the method further including:
 directing each of the second dilator open tip and at least a portion of the second dilator distal end at least one of adjacent to and at least partially into the first dilator side wall opening; and 
 with the second dilator distal end at least one of adjacent to and at least partially in the first dilator side wall opening, longitudinally moving the first dilator toward a proximal direction to remove the first dilator from the guidewire, wherein as the first dilator is moved toward the proximal direction, the second dilator distal end selectively urges the first dilator open slit first surface elastically apart from the first dilator open slit second surface and the first dilator is removed from the guidewire, while maintaining the guidewire at the target patient site. 
 
     
     
       4. The method of  claim 1 , including:
 providing a third dilator, the third dilator having an elongate third dilator body and a third dilator distal end, the third dilator having a third dilator outer surface and a third dilator inner lumen, the third dilator distal end having a third dilator open tip, the third dilator having a third dilator side wall opening, the third dilator side wall opening selectively placing the third dilator outer surface in fluid communication with the third dilator inner lumen, the third dilator having a third dilator open slit, the third dilator open slit extending between the third dilator side wall opening and the third dilator open tip; 
 directing the guidewire proximal end into the third dilator open tip, through at least a portion of the third dilator inner lumen, and out from the third dilator through the third dilator side wall opening; 
 directing the third dilator into the target patient tissue site along the guidewire until the third dilator open tip is adjacent to the first dilator side wall opening; and 
 directing the second dilator into the target patient tissue site along the guidewire until the second dilator open tip is adjacent to the third dilator side wall opening. 
 
     
     
       5. The method of  claim 4 , including:
 placing the third dilator into a predetermined relationship with the first dilator, wherein the third dilator open tip is adjacent to the first dilator side wall opening; 
 placing the second dilator into a predetermined relationship with the third dilator, wherein the second dilator open tip is adjacent to the third dilator side wall opening; 
 directing the guidewire proximal end into the first dilator open tip and out of the second dilator, wherein the guidewire proximal end is directed through the first dilator open tip and at least a portion of the first dilator inner lumen, through the first dilator side wall opening, through the third dilator open tip and at least a portion of the third dilator inner lumen, through the third dilator side wall opening, through the second dilator open tip and the second dilator inner lumen, and out from the second dilator; and 
 collectively inserting the first dilator, the second dilator, and the third dilator into the target patient tissue site along the guidewire. 
 
     
     
       6. The method of  claim 4 , wherein first dilator has a first dilator open slit, the first dilator open slit extending between the first dilator side wall opening and the first dilator open tip, the first dilator open slit including a first dilator open slit first surface and a first dilator open slit second surface, the first dilator open slit first surface being oppositely facing and abutting the first dilator open slit second surface, the first dilator open slit first surface and the first dilator open slit second surface being selectively elastically separable, and the third dilator open slit includes a third dilator open slit first surface and a third dilator open slit second surface, the third dilator open slit first surface being oppositely facing and abutting the third dilator open slit second surface, the third dilator open slit first surface and the third dilator open slit second surface being selectively elastically separable, the method further including:
 directing at least a portion of the second dilator distal end at least one of adjacent to and at least partially into the third dilator side wall opening; 
 with the second dilator distal end at least one of adjacent to and at least partially in the third dilator side wall opening, longitudinally moving the third dilator toward a proximal direction to remove the third dilator from the guidewire, wherein as the third dilator is moved toward the proximal direction, the second dilator distal end selectively urges the third dilator open slit first surface elastically apart from the third dilator open slit second surface and the third dilator is removed from the guidewire, while maintaining the guidewire at the target patient site; 
 directing at least a portion of the second dilator distal end at least one of adjacent to and at least partially into the first dilator side wall opening; and 
 with the second dilator distal end at least one of adjacent to and at least partially in the first dilator side wall opening, longitudinally moving the first dilator toward a proximal direction to remove the first dilator from the guidewire, wherein as the first dilator is moved toward the proximal direction, the second dilator distal end selectively urges the first dilator open slit first surface elastically apart from the first dilator open slit second surface and the first dilator is removed from the guidewire, while maintaining the guidewire at the target patient site. 
 
     
     
       7. The method of  claim 1 , wherein the second dilator open tip and at least a portion of the second dilator distal end that are each smaller in diameter than at least one of a third dilator inner lumen and a third dilator side wall opening, the method further including:
 providing a third dilator, the third dilator having an elongate third dilator body and a third dilator distal end, the third dilator having a third dilator outer surface and a third dilator inner lumen, the third dilator distal end having a third dilator open tip, the third dilator having a third dilator side wall opening, the third dilator side wall opening selectively placing the third dilator outer surface in fluid communication with the third dilator inner lumen, the third dilator having a third dilator open slit, the third dilator open slit extending between the third dilator side wall opening and the third dilator open tip, the third dilator open tip and at least a portion of the third dilator distal end each being smaller in diameter than at least one of the first dilator inner lumen and the first dilator side wall opening; 
 inserting the second dilator open tip and at least a portion of the second dilator distal end into the third dilator inner lumen through the third dilator side wall opening; 
 inserting the third dilator open tip and at least a portion of the third dilator distal end into the first dilator inner lumen through the first dilator side wall opening; 
 directing the guidewire proximal end into the first dilator open tip and out of the second dilator, wherein the guidewire proximal end is directed through the first dilator open tip and at least a portion of the first dilator inner lumen, through the third dilator open tip and at least a portion of the third dilator inner lumen, through the second dilator open tip and the second dilator inner lumen, and out from the second dilator; and 
 collectively inserting the first dilator, the second dilator, and the third dilator into the target patient tissue site along the guidewire. 
 
     
     
       8. The method of  claim 7 , wherein first dilator has a first dilator open slit, the first dilator open slit extending between the first dilator side wall opening and the first dilator open tip, the first dilator open slit including a first dilator open slit first surface and a first dilator open slit second surface, the first dilator open slit first surface being oppositely facing and abutting the first dilator open slit second surface, the first dilator open slit first surface and the first dilator open slit second surface being selectively elastically separable, and the third dilator open slit including a third dilator open slit first surface and a third dilator open slit second surface, the third dilator open slit first surface being oppositely facing and abutting the third dilator open slit second surface, the third dilator open slit first surface and the third dilator open slit second surface being selectively elastically separable, the method further including:
 with the third dilator distal end at least partially in the first dilator side wall opening, longitudinally moving the first dilator toward a proximal direction to remove the first dilator from the guidewire, wherein as the first dilator is moved toward the proximal direction, the third dilator distal end selectively urges the first dilator open slit first surface elastically apart from the first dilator open slit second surface and the first dilator is removed from the guidewire, while maintaining the guidewire at the target patient site; and 
 with the second dilator distal end at least partially in the third dilator side wall opening, longitudinally moving the third dilator toward a proximal direction to remove the third dilator from the guidewire, wherein as the third dilator is moved toward the proximal direction, the second dilator distal end selectively urges the third dilator open slit first surface elastically apart from the third dilator open slit second surface and the third dilator is removed from the guidewire, while maintaining the guidewire at the target patient site.